Impact of Laterality on Cumulative Survival in Patients Diagnosed with Retinoblastoma: A Retrospective Cohort Analysis of 1925 Cases in the Surveillance, Epidemiology, and End Results (SEER) Program

Abstract

Background Retinoblastoma is an intraocular cancer with potentially severe clinical consequences if left untreated. Diagnostic and clinical management guidelines are strictly dependent on nature of laterality. This analysis aims to characterize the influence of laterality on survival in patients diagnosed with retinoblastoma. Methods This retrospective cohort analysis utilized the Surveillance, Epidemiology, and End Results (SEER) program for population-based clinical data from 1975 to 2016, a period of 41 years. Univariable and multivariable Cox regression assessed survival with laterality as the primary independent predictor of mortality. Adjustment for demographical and clinical variables was performed. Results N = 1925 patients with a valid cause of death classification. Mean±SD age was 2.35±2.020 years (range 0–74). At the time of diagnosis, 819 (42.1%) patients were between 0 and 1 year of age, 469 (24.1%) patients were between 1 and 2 years, 350 (18.0%) patients were between 2 and 3 years, 147 (7.6%) patients were between 3 and 4 years, and 68 (3.5%) patients were between 4 and 5 years of age. The hazard of univariable cause-specific death is 55.6% and 52.9% lower for retinoblastoma patients with left-sided origin and right-sided origin as compared to patients with bilateral origin, respectively (HR = 0.444, CI 0.247–0.800, p = 0.007; HR = 0.471, CI 0.267–0.832, p = 0.009). After adjusting for confounding variables, the hazard of other-cause death for retinoblastoma patients is significantly less for left-sided origin (HR = 0.364, CI 0.140–0.946, p = 0.038) and right-sided origin (HR = 0.190, CI 0.066–0.549, p = 0.002) as compared to patients with retinoblastomas of bilateral origin. Conclusion Prognostication of survival is significantly influenced by the nature of laterality in retinoblastoma. Unilateral retinoblastomas showcase increased promise for long-term cause-specific and other-cause survival compared to cases of retinoblastoma arising from bilateral origin.

When left does not seem right: epigenetic and bioelectric differences between left- and right-sided breast cancer

“…Differences in L/R bilateral tumors have been reported for several cancer types, like breast (Kenney et al 2004 ; Garfinkel et al 1959 ), colon (Yang et al 2018 ; Baran et al 2018 ; Sponholz et al 2021 ), kidney (Ni et al 2021 ; Guo et al 2019 ), brain (Połczyńska et al 2021 ), ovary (He et al 2021 ), and eye (Hussain 2021 ). Particularly in breast tumors, in addition to the largely known increased L-side incidence (Busk and Clemmensen 1947 ; Roychoudhuri et al 2006 ), interesting differences in gene expression (Robichaux et al 2014 ; Mittwoch 2008 ), gland microbiota (Klann et al 2020 ), mitochondria distribution (Mishra and Chan 2014 ) and methylation profiles (Campoy et al 2016 ) have been reported.…”

Philippine retinoblastoma initiative multi-eye center study 2010-2020

“…This can be from factors cited earlier on the similarity of International Retinoblastoma Staging System stages between patients with unilateral and bilateral disease. Generally, patients with unilateral disease were found to have higher survival rates compared to those with bilateral disease, with the latter having a 1900% increased hazard risk [39][40] . Another series attributed this to higher proportion of extraocular disease and increased incidence of secondary neoplasms among those with bilateral disease [41] .…”

When Left Does Not Seem Right: Epigenetic and Bioelectric Differences Between Left- and Right-Sided Breast Cancer

“…Differences in L/R bilateral tumors have been reported for several cancer types, like breast [36], [37], colon [9], [38], [39], kidney [40], [41], brain [42], ovary [43], and eye [44]. Particularly in breast tumors, in addition to the largely known increased L-side incidence [45] [46], interesting differences in gene expression [8] [33], gland microbiota [47], mitochondria distribution [48] and methylation profiles [10] have been reported.…”